Provider Demographics
NPI:1962768176
Name:FERREIRA, KATELYN SUZANNE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KATELYN
Middle Name:SUZANNE
Last Name:FERREIRA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:KATELYN
Other - Middle Name:SUZANNE
Other - Last Name:KEOHANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:20 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-7414
Mailing Address - Country:US
Mailing Address - Phone:401-527-2474
Mailing Address - Fax:
Practice Address - Street 1:735 PUTNAM PIKE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:RI
Practice Address - Zip Code:02828-1435
Practice Address - Country:US
Practice Address - Phone:401-949-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT01125225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist